Medicare Is Faulted in Electronic Medical Records Conversion

The conversion to electronic medical records — a critical piece of the Obama administration’s plan for health care reform — is “vulnerable” to fraud and abuse because of the failure of Medicare officials to develop appropriate safeguards, according to a sharply critical report to be issued Thursday by federal investigators.

Mike Spencer/Wilmington Star-News, via Associated Press

Celeste Stephens, a nurse, leads a session on electronic records at New Hanover Regional Medical Center in Wilmington, N.C.

Centers for Medicare and Medicaid Services

Marilyn Tavenner, acting administrator for Medicare.

The use of electronic medical records has been central to the aim of overhauling health care in America. Advocates contend that electronic records systems will improve patient care and lower costs through better coordination of medical services, and the Obama administration is spending billions of dollars to encourage doctors and hospitals to switch to electronic records to track patient care.

But the report says Medicare, which is charged with managing the incentive program that encourages the adoption of electronic records, has failed to put in place adequate safeguards to ensure that information being provided by hospitals and doctors about their electronic records systems is accurate. To qualify for the incentive payments, doctors and hospitals must demonstrate that the systems lead to better patient care, meeting a so-called meaningful use standard by, for example, checking for harmful drug interactions.

Medicare “faces obstacles” in overseeing the electronic records incentive program “that leave the program vulnerable to paying incentives to professionals and hospitals that do not fully meet the meaningful use requirements,” the investigators concluded. The report was prepared by the Office of Inspector General for the Department of Health and Human Services, which oversees Medicare.

The investigators contrasted the looser management of the incentive program with the agency’s pledge to more closely monitor Medicare payments of medical claims. Medicare officials have indicated that the agency intends to move away from a “pay and chase” model, in which it tried to get back any money it has paid in error, to one in which it focuses on trying to avoid making unjustified payments in the first place.

Late Wednesday, a Medicare spokesman said in a statement: “Protecting taxpayer dollars is our top priority and we have implemented aggressive procedures to hold providers accountable. Making a false claim is a serious offense with serious consequences and we believe the overwhelming majority of doctors and hospitals take seriously their responsibility to honestly report their performance.”

The government’s investment in electronic records was authorized under the broader stimulus package passed in 2009. Medicare expects to spend nearly $7 billion over five years as a way of inducing doctors and hospitals to adopt and use electronic records. So far, the report said, the agency has paid 74, 317 health professionals and 1,333 hospitals. By attesting that they meet the criteria established under the program, a doctor can receive as much as $44,000 for adopting electronic records, while a hospital could be paid as much as $2 million in the first year of its adoption. The inspector general’s report follows earlier concerns among regulators and others over whether doctors and hospitals are using electronic records inappropriately to charge more for services, as reported by The New York Times last September, and is likely to fuel the debate over the government’s efforts to promote electronic records. Critics say the push for electronic records may be resulting in higher Medicare spending with little in the way of improvement in patients’ health. Thursday’s report did not address patient care.

Even those within the industry say the speed with which systems are being developed and adopted by hospitals and doctors has led to a lack of clarity over how the records should be used and concerns about their overall accuracy.

“We’ve gone from the horse and buggy to the Model T, and we don’t know the rules of the road. Now we’ve had a big car pileup,” said Lynne Thomas Gordon, the chief executive of the American Health Information Management Association, a trade group in Chicago. The association, which contends more study is needed to determine whether hospitals and doctors actually are abusing electronic records to increase their payments, says it supports more clarity.

Although there is little disagreement over the potential benefits of electronic records in reducing duplicative tests and avoiding medical errors, critics increasingly argue that the federal government has not devoted enough time or resources to making certain the money it is investing is being well spent.

House Republicans echoed these concerns in early October in a letter to Kathleen Sebelius, secretary of health and human services. Citing the Times article, they called for suspending the incentive program until concerns about standardization had been resolved. “The top House policy makers on health care are concerned that H.H.S. is squandering taxpayer dollars by asking little of providers in return for incentive payments,” said a statement issued at the same time by the Republicans, who are likely to seize on the latest inspector general report as further evidence of lax oversight. Republicans have said they will continue to monitor the program.

In her letter in response, which has not been made public, Ms. Sebelius dismissed the idea of suspending the incentive program, arguing that it “would be profoundly unfair to the hospitals and eligible professionals that have invested billions of dollars and devoted countless hours of work to purchase and install systems and educate staff.” She said Medicare was trying to determine whether electronic records had been used in any fraudulent billing but she insisted that the current efforts to certify the systems and address the concerns raised by the Republicans and others were adequate.

This article has been revised to reflect the following correction:

Correction: November 30, 2012

An article on Thursday about a federal report critical of Medicare’s performance in assuring accuracy as doctors and hospitals switch to electronic medical records misstated, in some copies, the timing of a statement from a Medicare spokesman in response to the report. The statement was released late Wednesday, not late Thursday.

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Groupon board ends meeting; takes no action on CEO Mason's job

Groupon CEO Andrew Mason at the Nasdaq after his company's initial public offering in 2011. (Brendan McDermid/Reuters / November 29, 2012)

By Melissa Harris




Tribune reporter

3:14 p.m. CST, November 29, 2012

Today's meeting of Groupon's board of directors concluded minutes ago with no announced action on chief executive Andrew Mason's job, according to the company's spokesman.

For now, it appears Mason will continue leading the daily deals company as it seeks to turn around its sluggish performance in Europe, expand its offerings and draw in more customers via Google search vs. email blasts.

"The meeting is over and the board and management team are keenly focused on the performance of the company," said company spokesman Paul Taaffe. "And they are all working together with their heads down to achieve Groupon's objectives."

mmharris@tribune.com | Twitter @ChiConfidential

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Starters and reserves make short work of Mavs

About the only thing missing from the Bulls' 101-78 victory over the Mavericks Wednesday night was the United Center faithful breaking out a "Rad-man-o-vic" chant, a la "Scal-a-brine" from seasons past.

Otherwise, the Bulls and Tom Thibodeau responded to Monday's debacle against the Bucks, in which they blew a 27-point lead while riding the starters, with resolve and reserves. Lots and lots of reserves.

Taj Gibson, Jimmy Butler, Nate Robinson and even Marco Belinelli and Nazr Mohammed changed the complexion of the game during a second quarter in which the Bulls outscored the Mavericks 34-19.

On Monday, reserves played a total of 40 minutes, 2 seconds. They played 43:03 in the second quarter alone.

"The bench was great," Thibodeau said. "The starters got us off to a good start. We needed everybody. The defense and rebounding was very good. Overall, I thought we played a lot tougher with the lead."

And, yes, the Bulls led by 27 at one point and by as many as 29.

Luol Deng scored 22 points and Joakim Noah posted his sixth double-double with 13 points and 10 rebounds to prove starters still have a pulse. But for at least one night, the reserves were the story for positive reasons.

"I don't think any of them were happy sitting last game," Deng said. "They responded great."

Robinson's 14 points led the Bulls' 50-34 edge in bench points. Butler added a career-high 13 points. Belinelli, who didn't play last game, contributed 11 points.

"If you care about the team and playing basketball, you have to be mad," Belinelli said of not playing Monday. "So I was really mad. We lost and I didn't play. I have to play more aggressive."

Mohammed, who hadn't played the last three games, added five rebounds, two blocks and the dunk that put the Bulls over the century mark for free fast-food sandwiches for the fans. Thibodeau said the Mavericks' big centers were good matchups for the veteran and passionately defended his overall playing-time approach.

"My decisions have to be based on what's best for the team," Thibodeau said. "I've always been that way and I'm not going to change.

"The scoreboard tells you. When a group is maintaining or building a lead, then they're going to play longer. If the lead is not going the right direction, then you have to make adjustments. Everything is based on performance. That's the only way you can do it."

The Bulls also flashed stout defense, holding the Mavericks to 34.6 percent shooting. A nicked-up O.J. Mayo, who entered averaging a team-high 20.8 points, managed a season-low four points on 2-for-9 shooting.

The blowout allowed all 12 Bulls to see action. And, yes, that meant Vladimir Radmanovic, who, in lieu of Brian Scalabrine-type chants, drew cheers when he dropped in a sweet pass from Butler late.

"This was important," Butler said. "We had to bounce back."

kcjohnson@tribune.com

Twitter @kcjhoop

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Family learns of student’s death on Facebook

ATLANTA (AP) — The parents of a south Georgia college student first learned from Facebook that their daughter had been found dead in a dormitory study room shortly before Thanksgiving. Now, they hope that Facebook and other social media sites can help solve the death of 17-year-old Jasmine Benjamin, which police are investigating as a homicide.

The Valdosta State University freshman was found unresponsive on a study room couch on Nov. 18.

A family friend forwarded the Facebook post about the teen’s death to her parents before they were officially notified by authorities, said A. Thomas Stubbs, an attorney for the victim’s mother, Judith Brogdon, and her stepfather, James Jackson. But many questions remain unanswered about how she died.

The family has hired a private investigator, and a new Facebook site has been set up in hopes that students and others might share tips.

While some Facebook comments have already been turned over to law enforcement officers, the family hopes friends, classmates or others who noticed suspicious comments will also alert authorities.

“Anything that reveals a little more information than what’s publicly known about her death, those are the kind of comments police are looking for as someone who might warrant a closer examination,” Stubbs said.

Also of interest are “unusual comments or unusually timed comments about her death,” he said.

Police detectives have canvassed dormitories and interviewed several students on the campus, located about 250 miles south of the family’s home in Gwinnett County, outside Atlanta.

Benjamin wanted to follow the career path of her mother and become a nurse.

Police say they’re treating the case as a homicide, though autopsy results are not complete and they can’t say for certain whether she was killed. There were no obvious signs of a crime when her body was found, but an autopsy raised questions, authorities have said.

“We’re providing what resources are necessary to assist Valdosta State University police in solving this crime,” Georgia Bureau of Investigation spokesman John Bankhead said. “The crime lab is expediting evidence from this incident.”

Shortly after Benjamin’s parents learned of her death from Facebook, Lawrenceville police officers knocked on the doors of the family home to inform them officially that their daughter was dead, Stubbs said.

“As frustrating as that may be for the family to learn that way, they understand it’s a different world,” Stubbs said.

The family has yet to learn the possible timeframe of when their daughter died, and police have not shared any theories about how she was killed, Stubbs said.

“We know that they have looked at the phone records, video records that they can find in the school,” he said. Beyond that, they’ve been going through legal procedures that are required to obtain records from Facebook Inc.

The family hired Martinelli Investigations Inc. of Lawrenceville to assist in the investigation.

Private investigator Robin Martinelli said Wednesday that any video near the scene, even if may seem insignificant, could prove helpful in the investigation.

“It wouldn’t matter if it was two weeks before, two hours before or 20 minutes before,” she said.

Martinelli said she’s confident that police are working diligently to follow up on leads, but private investigators can often provide valuable assistance, she said.

“On any homicide, they’re going to work around the clock aggressively every minute, and they’re doing that,” she said.

She said Jasmine Benjamin was a strong student who showed great potential. “Her favorite color was purple, her nickname was Jazzy,” she said.

“She wanted to help people, plain and simple,” her stepfather, James Jackson, told WSB-TV. “That was her goal in life. That’s all she talked about since she was young — ‘I want to be able to help people.’”

Valdosta State campus police, city police and the GBI were working together to conduct interviews and collect evidence, the university said in a statement Tuesday. University officials said they couldn’t release any further information.

Martinelli hopes students away at college keep in touch with their parents — and give them the passwords to social networking sites and their cell phones in case anything happens.

“If you have passcodes to your computer, your phone, please tell your parents,” she said. “Don’t tell everybody in the world, but tell your parents your passcodes.”

She said some of the best advice parents can give students is this: “They should listen to their gut,” she said. “If they walk into a situation and it’s not feeling right, leave.”

Social Media News Headlines – Yahoo! News

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Adele’s “21″ sells 10 million, Rihanna leads Billboard

LOS ANGELES (Reuters) – British singer and Grammy darling Adele reached the 10 million sales mark in the United States on Wednesday with her heartbreak album “21″ becoming the first by British woman to reach the milestone, Nielsen SoundScan said.

“21,” released in February 2011, produced the hits “Someone Like You” and “Rolling In The Deep” and became the top-selling album of 2011. Earlier this year, Adele swept the Grammy Awards with six, including song, record and album of the year.

“21″ became the third album to cross 10 million in 2012, along with Linkin Park‘s “Hybrid Theory” and Usher’s “Confessions.” But it is the only album to reach the milestone in less than two years in the last decade, Nielsen said.

“What an incredible honor,” Adele said in a statement. “A huge, huge thank you to my American fans for embracing this record on such a massive level.”

“21″ will receive the diamond certification from the Recording Industry Association of America, marking its 10 million milestone, joining the ranks of albums by artists such as Michael Jackson, The Beatles and Madonna.

“Adele‘s unique talent is a gift to music fans, and her success is certainly cause for a celebration of Diamond magnitude,” Cary Sherman, RIAA’s chairman & CEO, said in a statement.

Adele, 24, is enjoying the success of her latest single “Skyfall,” the official theme song for the James Bond film of the same name. It has sold more than 2 million copies worldwide. The singer also gave birth to her first child earlier this year.

On the Billboard 200 chart this week, R&B star Rihanna scored her first No. 1 album with “Unapologetic,” selling 238,000 copies.

She held off new entries from “American Idol” winner Phillip Phillips, who landed at No. 4 with his debut album “The World From the Side of the Moon,” and country-rock singer Kid Rock, who rounded out the top five with his latest album “Rebel Soul.”

(Reporting By Piya Sinha-Roy Editing by Jill Serjeant, Grant McCool and Andre Grenon)

Music News Headlines – Yahoo! News

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Well: Weight Loss Surgery May Not Combat Diabetes Long-Term

Weight loss surgery, which in recent years has been seen as an increasingly attractive option for treating Type 2 diabetes, may not be as effective against the disease as it was initially thought to be, according to a new report. The study found that many obese Type 2 diabetics who undergo gastric bypass surgery do not experience a remission of their disease, and of those that do, about a third redevelop diabetes within five years of their operation.

The findings contrast with the growing perception that surgery is essentially a cure for Type II diabetes. Earlier this year, two widely publicized studies reported that surgery worked better than drugs, diet and exercise in causing a remission of Type 2 diabetes in overweight people whose blood sugar was out of control, leading some experts to call for greater use of surgery in treating the disease. But the studies were small and relatively short, lasting under two years.

The latest study, published in the journal Obesity Surgery, tracked thousands of diabetics who had gastric bypass surgery for more than a decade. It found that many people whose diabetes at first went away were likely to have it return. While weight regain is a common problem among those who undergo bariatric surgery, regaining lost weight did not appear to be the cause of diabetes relapse. Instead, the study found that people whose diabetes was most severe or in its later stages when they had surgery were more likely to have a relapse, regardless of whether they regained weight.

“Some people are under the impression that you have surgery and you’re cured,” said Dr. Vivian Fonseca, the president for medicine and science for the American Diabetes Association, who was not involved in the study. “There have been a lot of claims about how wonderful surgery is for diabetes, and I think this offers a more realistic picture.”

The findings suggest that weight loss surgery may be most effective for treating diabetes in those whose disease is not very advanced. “What we’re learning is that not all diabetic patients do as well as others,” said Dr. David E. Arterburn, the lead author of the study and an associate investigator at the Group Health Research Institute in Seattle. “Those who are early in diabetes seem to do the best, which makes a case for potentially earlier intervention.”

One of the strengths of the new study was that it involved thousands of patients enrolled in three large health plans in California and Minnesota, allowing detailed tracking over many years. All told, 4,434 adult diabetics were followed between 1995 and 2008. All were obese, and all underwent Roux-en-Y operations, the most popular type of gastric bypass procedure.

After surgery, about 68 percent of patients experienced a complete remission of their diabetes. But within five years, 35 percent of those patients had it return. Taken together, that means that most of the subjects in the study, about 56 percent — a figure that includes those whose disease never remitted — had no long-lasting remission of diabetes after surgery.

The researchers found that three factors were particularly good predictors of who was likely to have a relapse of diabetes. If patients, before surgery, had a relatively long duration of diabetes, had poor control of their blood sugar, or were taking insulin, then they were least likely to benefit from gastric bypass. A patient’s weight, either before or after surgery, was not correlated with their likelihood of remission or relapse.

In Type 2 diabetes, the beta cells that produce insulin in the pancreas tend to wear out as the disease progresses, which may explain why some people benefit less from surgery. “If someone is too far advanced in their diabetes, where their pancreas is frankly toward the latter stages of being able to produce insulin, then even after losing a bunch of weight their body may not be able to produce enough insulin to control their blood sugar,” Dr. Arterburn said.

Nonetheless, he said it might be the case that obese diabetics, even those whose disease is advanced, can still benefit from gastric surgery, at least as far as their quality of life and their risk factors for heart disease and other complications are concerned.

“It’s not a surefire cure for everyone,” he said. “But almost universally, patients lose weight after weight loss surgery, and that in and of itself may have so many health benefits.”

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Groupon CEO Mason offers to step down

Groupon Inc Chief Executive Andrew Mason, under fire for a plunging share price and tapering growth, declared on Wednesday he would fire himself if he ever thought he was the wrong man for the job.

Mason, whose performance at the helm will come under scrutiny from his board of directors during a regular board meeting Thursday, said it would be "weird" if they did not. But he said he believed the board was comfortable with his strategy.

Shares in the company, once touted as innovating local business advertising t hrough the marketing of Internet discounts on everything from spa treatments to dining, surged 8 percent to $4.25 i n the afternoon.

"It would be more noteworthy if the board wasn't discussing whether I'm the right guy for the job," Mason said in an interview from a Business Insider conference in New York. "If I ever thought I wasn't the right guy for the job, I'd be the first person to fire myself."

"As the founder and creator of Groupon, as a large shareholder ... I care far more about the success of the business than I do about my role as CEO," he said.

Groupon has shed four-fifths of its value since its public trading debut as an investor favorite during last year's consumer dotcom IPO boom, and Mason himself has presided over a string of high-profile executive departures.

Wall Street has grown uneasy about the viability of its business as fever for daily deals has cooled among consumers and merchants, hurting its growth rate.

In the interview broadcast from the conference, the outspoken and sometimes-zany co-founder argued his company was going through a period of volatility but believed it was on the right path. Groupon's efforts to reduce its reliance on plain vanilla deals include bumping up its "Goods" retail business, increasing the selection of "persistent" or long-running deals, and allowing users to search for such deals on demand.

Shares in Groupon spiked after the interview and were up 8 p ercent at $4.2 6, still way below its $20 market debut price.

Groupon and rivals in the daily deals business, like Amazon.com-backed LivingSocial, were supposed to change the very nature of small-business advertising. Instead, they were forced to revamp their business models as evidence mounts that their strategy was flawed.

This month, Groupon reported another quarter of disappointing earnings, and its stock went as low as $2.60 on Nov. 12.

Europe has been a particular problem for Groupon, partly because the sovereign debt crisis has sapped demand for higher-priced deals. Groupon was also offering steeper discounts, turning off some European merchants.

International revenue, which includes Europe, grew just 3 percent to $277 million in the third quarter, while North American revenue surged 80 percent to $292 million.

Adding to its difficulties, the U.S. Securities and Exchange Commission is looking into Groupon's accounting and disclosures, areas that raised questions among some analysts during its IPO.

But Mason shrugged off speculation that the company might run into a cash crunch and go bankrupt. The company has said it had $1.2 billion in cash and equivalents with no long-term debt.

"There was a period when those stories started that I'd go to my CFO and say: 'How would that happen, walk me through what would be required for us to actually go bankrupt'," Mason said. "And it's like an end of days, apocalyptic scenario. The business would have to go into severe negative growth for something like this. The scenario is so absurd there's no evidence for it."

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Cicero election heats up as foes trade gang accusations

Things are starting to get ugly in the race for president of Cicero — a town where political hardball is commonplace.

Incumbent Larry Dominick, who will be seeking a third term as town president in February, has moved quickly to denounce one of his four challengers, former McPier executive Juan Ochoa.

Ochoa, who has the backing of U.S. Rep. Luis Gutierrez, D-Ill., is hoping to win a majority of Cicero's Hispanic vote. The west suburb is about 80 percent Hispanic.

But Dominick's campaign is trying to link Ochoa and his campaign workers to a Chicago street gang. Dominick officials say gang members are knocking on doors throughout town to promote Ochoa's run for office.

Ochoa said no current gang members work for his campaign.

"Many of these individuals are volunteers for CeaseFire (now Cure Violence) and are former gang members who are now out helping people," Ochoa said of the staffers. "Dominick also uses CeaseFire volunteers to assist him with his campaign. Many of them, of course, are reformed gang members."

Dominick would not comment for this story, but Cicero town spokesman Ray Hanania said, "Dominick is probably using CeaseFire members and volunteers to help him get re-elected." But he added that some of the individuals on the Ochoa campaign have been included by the Chicago Crime Commission in its current book of known gang members.

"That's the difference," Hanania said. "Our guys aren't in that book."

Ochoa said he doesn't understand what relevance that has.

Meanwhile, Ochoa is accusing Dominick of putting two other Hispanic candidates on the ballot to draw votes from him, accusations the candidates and Hanania deny.

Ochoa also is claiming that Dominick is using the town police for his benefit.

On Election Day earlier this month, Cicero police officials charged a 55-year-old campaign worker for Ochoa with disorderly conduct for allegedly "sexually" threatening a female poll worker at a polling place, authorities said. The town immediately issued a news release after the incident, linking the campaign worker to a Chicago street gang.

The woman, who pressed charges against the man, happens to be a secretary for Dominick, according to Hanania.

"He never said anything to her," Ochoa said. "All of a sudden 10 police officers come to arrest him. (The man) is a grandpa, for goodness' sake."

Hanania, who also is a spokesman for the Police Department, said details about the number of officers involved weren't available, but he added that typically three or four officers respond when an arrest is made.

Ochoa said it also angers him that police came to the scene and made the arrest but made no arrests during a scuffle among campaign workers representing the two political parties at the Cicero/Berwyn Houby Festival in October.

"We called 911, the police did come, but they didn't arrest anyone," Ochoa said.

According to Ochoa, the incident occurred after a truck denouncing him and Gutierrez attempted to block Ochoa and his campaign workers while they were walking in the parade. The billboard on the flat truck read "Tell Luis Gutierrez and Juan Ochoa to take their Street Gang Friends back to Chicago."

Hanania said Dominick's campaign sponsored the truck, but the spokesman added that he was told by town officials that the incident did not warrant any arrests.

Ochoa said the while the incidents can be distracting, he is trying to stay focused on his campaign and his message.

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Ex-Elmo puppeteer faces new sex-with-minor allegation

NEW YORK (Reuters) – The puppeteer formerly behind the “Sesame Street” character Elmo faces a new accusation of having sex with an underage boy, a week after a similar allegation prompted him to resign from the iconic public television children’s program.

In a lawsuit filed Tuesday in U.S. District Court in Manhattan, a man identified only as John alleges Kevin Clash engaged in oral sex and other sex acts with him when John was 16 years old. The suit seeks at least $ 75,000 in damages.

The suit alleges the incident occurred in either 2000 or 2001 when John, who is from Florida, visited New York for modeling opportunities. John came to know Clash, then 40, through a telephone chat line for gays on which Clash claimed to be a 30-year-old named Craig, according to the suit.

John returned to New York when he turned 18, and he and Clash renewed the relationship, the lawsuit said.

“Mr. Clash believes the lawsuit has no merit,” Clash’s publicist, Risa B. Heller, said in an emailed statement.

It is the latest charge levied against Clash, now 52, who resigned on November 20 from Sesame Workshop, the company behind “Sesame Street,” after nearly 30 years on the show.

His resignation came the same day Cecil Singleton filed a claim seeking more than $ 5 million in damages from Clash. Singleton claims he met the then-32-year-old puppeteer in 1993 in a gay chat room when he was 15.

It added that on numerous occasions over a period of years Clash engaged in sexual activity with Singleton.

The newest allegation comes about two weeks after another man recanted his claims that Clash had sex with him when he was 16 years old. The man later said the relationship was consensual.

Clash had denied the allegations and acknowledged a past relationship with his first accuser. He added the pair were both consenting adults at the time.

The Elmo character debuted on “Sesame Street” in 1979, 10 years after the show premiered and introduced the now-iconic characters Big Bird, Bert and Ernie, Oscar the Grouch and Cookie Monster, among others, to American children.

While Clash was the third performer to animate the child-like shaggy red monster, Sesame Workshop credits him with turning Elmo into the international sensation he became.

(Reporting by Dan Burns; Editing by Paul Thomasch and Cynthia Osterman)

Celebrity News Headlines – Yahoo! News

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Amid Hurricane Sandy, a Race to Get a Liver Transplant

It was the best possible news, at the worst possible time.

The phone call from the hospital brought the message that Dolores and Vin Dreeland had long hoped for, ever since their daughter Natalia, 4, had been put on the waiting list for a liver transplant. The time had come.

They bundled her into the car for the 50-mile trip from their home in Long Valley, N.J., to NewYork-Presbyterian Morgan Stanley Children’s Hospital in Manhattan. But it soon seemed that this chance to save Natalia’s life might be just out of reach.

The date was Sunday, Oct. 28, and Hurricane Sandy, the worst storm to hit the East Coast in decades, was bearing down on New York. Airports and bridges would soon close, but the donated organ was in Nevada, five hours away. The time window in which a plane carrying the liver would be able to land in the region was rapidly closing.

In a hospital room, Natalia watched cartoons. Her parents watched the clock, and the weather. “Our anxiety was through the roof,” Mrs. Dreeland said. “It just made your stomach into knots.”

The Dreelands, who are in their 60s, became Natalia’s foster parents in 2008 when she was 7 months old, and adopted her just before she turned 2. They have another adopted daughter, Dorothy Jane, who is 17.

Natalia is a “smart little cookie” who loves school and dressing up Alice, her favorite doll, her mother said. At age 3, Natalia used the word “discombobulated” correctly, Mr. Dreeland said.

Natalia’s health problems date back several years. Her gallbladder was taken out in 2010, and about half her liver was removed in 2011. The underlying problem was a rare disease, Langerhans cell histiocytosis. It causes a tremendous overgrowth of a type of cell in the immune system and can damage organs. Drugs can sometimes keep it in check, but they did not work for Natalia.

In her case, the disease struck the bile ducts, which led to progressive liver damage. “She would have eventually gone into liver failure,” said Dr. Nadia Ovchinsky, a pediatric liver transplant specialist at NewYork-Presbyterian. “And she demonstrated some signs of early liver failure.”

The only hope was a transplant.

Dr. Tomoaki Kato, Natalia’s surgeon, knew that the liver in Nevada was a perfect match for Natalia in the two criteria that matter most: blood type and size. The deceased donor was 2 years old, and though Natalia is nearly 5, she is small for her age. Scar tissue from her previous operations would have made it very difficult to fit a larger organ into her abdomen.

Though Dr. Kato had considered transplanting part of an adult liver into Natalia, a complete organ from a child would be far better for her. But healthy organs from small children do not often become available, Dr. Kato said. This was a rare opportunity, and he was determined to seize it.

But as the day wore on, the odds for Natalia grew slimmer. The operation in Nevada to remove the liver was delayed several times.

At many hospitals, surgery to remove donor organs is done at the end of the day, after all regularly scheduled operations. The Nevada hospital had a busy surgical schedule that day, made worse by a trauma case that took priority.

At the hospital in New York, Tod Brown, an organ procurement coordinator, had alerted a charter air carrier that a flight from Nevada might be needed. That company in turn contacted West Coast carriers to pick up the donated liver and fly it to New York.

Initially, two carriers agreed, but then backed out. Several other charter companies also declined.

Mr. Brown told Dr. Kato that they might have to decline the organ. Dr. Kato, soft-spoken but relentless, said, “Find somebody who can fly.”

Dr. Kato used to work in Miami, where pilots found ways to bypass hurricanes to deliver organs. Even during Hurricane Katrina, his hospital performed transplants.

“I asked the transplant coordinators to just keep pushing,” he said.

Mr. Brown said, “Dr. Kato knew he was going to get that organ, one way or another.”

As the trajectory of the storm became clearer, one of the West Coast charter companies agreed to attempt the flight. The plan was to land at the airport in Teterboro, N.J. The backup was Newark airport, and the second backup was Albany, from where an ambulance would finish the trip.

The timing was critical: organs deteriorate outside the body, and ideally a liver should be transplanted within 12 hours of being removed.

Early Monday, as the storm whirled offshore, the plane landed at Teterboro. Soon a nurse rushed to tell the Dreelands that she had just seen an ambulance with lights and sirens screech up to the hospital. Someone had jumped out carrying a container.

At about 5 a.m., the couple kissed Natalia and saw her wheeled off to the operating room.

Three weeks later, she is back home, on the mend. The complicated regimen of drugs that transplant patients need is tough on a child, but she is getting through it, her father said.

Recently, Mr. Dreeland said, he found himself weeping uncontrollably during a church service for the family of the child who had died. “Their child gave my child life,” he said.

Though only time will tell, because the histiocytosis appeared limited to Natalia’s bile ducts and had not affected other organs, her doctors say there is a good chance that the transplant has cured her.

This article has been revised to reflect the following correction:

Correction: November 28, 2012

Because of an editing error, a picture caption with an article on Tuesday about a girl who received a liver transplant during Hurricane Sandy misspelled the surname of the girl’s family. As the article correctly noted, it is Dreeland, not Vreeland.

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